1.Clinical analysis of diagnosis and treatment thyroid microcarcinoma
Wenjun SUO ; Ming LI ; Youfang GONG ; Xiuran DU
Clinical Medicine of China 2009;25(3):310-312
Objective To investigate the clinical characteristics,diagnosis and therapeutic principle of thyroid microcarcinoma(TMC).Metllotis Clinical data of 29 TMC cases from January 1997 to December 2006 were retrospectively analyzed.Results 27 cases were performed B-ultrasonography and minimal lesion of thyroid Was detected in all patients,5 cases were diagnosed as TMC suspiciously,of whom 1 case was found to have lymph node swell in cervical part and was diagnosed as metastasis thyroid cancer by lymph node biopsy.All cases took operation and experienced intra operative frozen section and paraffin section evaluation,indicating that 23 cases were confirmed by intra operative frozen section and 6 cases were confirmed by paraffin section.All cases were followed up after operation,of whom 2 patients undergoing homo-lateral near total thyroidectomy experienced recurrent after 2 years and 3 years operation respectively,and one patient died from cerebral hemorrhage.Conclusion Though it is difficult to confirm the diagnosis of TMC before operation,B-uhrasonography before operation combined with frozen section intra operation is the effective diagnostic method,and homolateral lobe and isthmus total thyroidectomy is the fundamental operation management.
2.Research on grading prediction model of traumatic hemorrhage volume based on deep learning
Chengyu GUO ; Youfang HAN ; Minghui GONG ; Hongliang ZHANG ; Junkang WANG ; Ruizhi ZHANG ; Bing LU ; Chunping LI ; Tanshi LI
Chinese Critical Care Medicine 2022;34(7):746-751
Objective:To develop a grading prediction model of traumatic hemorrhage volume based on deep learning and assist in predicting traumatic hemorrhage volume.Methods:A retrospective observational study was conducted based on the experimental data of pig gunshot wounds in the time-effect assessment database for experiments on war-traumatized animals constructed by the General Hospital of the Chinese People's Liberation Army. The hemorrhage volume data of the study population were extracted, and the animals were divided into 0-300 mL, 301-600 mL, and > 600 mL groups according to the hemorrhage volume. Using vital signs indexes as the predictive variables and hemorrhage volume grading as the outcome variable, trauma hemorrhage volume grading prediction models were developed based on four traditional machine learning and ten deep learning methods. Using laboratory test indexes as predictive variables and hemorrhage volume grading as outcome variables, trauma hemorrhage volume grading prediction models were developed based on the above fourteen methods. The effect of the two groups of models was evaluated by accuracy and area under the receiver operator characteristic curve (AUC), and the optimal models in the two groups were mixed to obtain hybrid model 1. Feature selection was conducted according to the genetic algorithm, and hybrid model 2 was constructed according to the best feature combination. Finally, hybrid model 2 was deployed in the animal experiment database system.Results:Ninety-six traumatic animals in the database were enrolled, including 27 pigs in the 0-300 mL group, 40 in the 301-600 mL group, and 29 in the > 600 mL group. Among the fourteen models based on vital signs indexes, fully convolutional network (FCN) model was the best [accuracy: 60.0%, AUC and 95% confidence interval (95% CI) was 0.699 (0.671-0.727)]. Among the fourteen models based on laboratory test indexes, recurrent neural network (RNN) model was the best [accuracy: 68.9%, AUC (95% CI) was 0.845 (0.829-0.860)]. After mixing the FCN and RNN models, the hybrid model 1, namely RNN-FCN model was obtained, and the performance of the model was improved [accuracy: 74.2%, AUC (95% CI) was 0.847 (0.833-0.862)]. Feature selection was carried out by genetic algorithm, and the hybrid model 2, namely RNN-FCN* model, was constructed according to the selected feature combination, which further improved the model performance [accuracy: 80.5%, AUC (95% CI) was 0.880 (0.868-0.893)]. The hybrid model 2 contained ten indexes, including mean arterial pressure (MAP), hematocrit (HCT), platelet count (PLT), lactic acid, arterial partial pressure of carbon dioxide (PaCO 2), Total CO 2, blood sodium, anion gap (AG), fibrinogen (FIB), international normalized ratio (INR). Finally, the RNN-FCN* model was deployed in the database system, which realized automatic, continuous, efficient, intelligent, and grading prediction of hemorrhage volume in traumatic animals. Conclusion:Based on deep learning, a grading prediction model of traumatic hemorrhage volume was developed and deployed in the information system to realize the intelligent grading prediction of traumatic animal hemorrhage volume.